title: The efficacy of self-expanding metal stents for malignant colorectal obstruction by noncolonic malignancy with peritoneal carcinomatosis.
abstract: BACKGROUND
  Although self-expanding metal stents for colorectal obstruction is preferred over emergency surgery, the efficacy of self-expanding metal stents in patients with malignant colorectal obstruction by a noncolonic malignancy with peritoneal carcinomatosis has not been demonstrated.
  
  
  OBJECTIVE
  The aim of this study was to evaluate the survival and long-term clinical outcome of self-expanding metal stents as the initial interventional approach in patients with malignant colorectal obstruction due to a noncolonic malignancy with peritoneal carcinomatosis.
  
  
  METHODS
  This is a retrospective study.
  
  
  METHODS
  This study was conducted at 2 tertiary care academic medical centers in South Korea.
  
  
  METHODS
  The patients were included who underwent self-expanding metal stent insertion for palliation of a malignant colorectal obstruction by a noncolonic malignancy with peritoneal carcinomatosis between July 2004 and January 2010. Inclusion criteria were incurable status, noncolorectal cancer, obstructive symptoms and/or signs, and colonoscopic findings of obstruction.
  
  
  METHODS
  The survival and success rate of patients undergoing self-expanding metal stents insertion was assessed.
  
  
  RESULTS
  Twenty patients were included during the study period. Technical success of self-expanding metal stents was achieved in 18/20 (90.0%) patients, and obstructive symptoms were resolved within 72 hours in 17/20 (85.0%) patients. Ten patients (10/20, 50%) did not need further intervention during the follow-up period after the first stent insertion. Eight patients ultimately underwent surgery during the follow-up period. One of the remaining 2 patients underwent additional endoscopic treatment without surgery. Another patient refused further intervention and thus received conservative management. Mean event-free survival was 119.0 days, and the mean overall survival of the included patients was 156.3 days.
  
  
  CONCLUSIONS
  The number of study patients was small.
  
  
  CONCLUSIONS
  Self-expanding metal stent insertion appears to be a reasonable first-treatment option in patients with malignant colorectal obstruction by noncolonic malignancy with peritoneal carcinomatosis.
authors.affiliation: 1 Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Republic of Korea 2 Department of Internal Medicine, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Republic of Korea.
authors.forename: Jung Ho
authors.initials: JH
authors.lastname: Kim
authors.forename: Yang Suh
authors.initials: YS
authors.lastname: Ku
authors.forename: Tae Joo
authors.initials: TJ
authors.lastname: Jeon
authors.forename: Ji Young
authors.initials: JY
authors.lastname: Park
authors.forename: Jun-Won
authors.initials: JW
authors.lastname: Chung
authors.forename: Kwang An
authors.initials: KA
authors.lastname: Kwon
authors.forename: Dong Kyun
authors.initials: DK
authors.lastname: Park
authors.forename: Yoon Jae
authors.initials: YJ
authors.lastname: Kim
mesh_terms: D000328:Adult; D000368:Aged; D002277:Carcinoma / Q000556:secondary*; D003108:Colonic Diseases / Q000628:therapy*; D005260:Female; D006801:Humans; D007415:Intestinal Obstruction / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications / Q000473:pathology; D010166:Palliative Care; D010534:Peritoneal Neoplasms / Q000556:secondary*; D012002:Rectal Diseases / Q000628:therapy*; D012086:Reoperation; D012189:Retrospective Studies; D015607:Stents